How one woman is trying to change native people's health care experience
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The crisis in Attawapiskat has left many Canadians feeling confused and dismayed about how such poor living conditions could exist in this country. It has also raised questions about broader relationships with aboriginal people across the country and about how to prevent similar problems from recurring.

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Janet Smylie, for one, has been working for years to find answers. Dr. Smylie is a Toronto-based family physician and health researcher of Métis heritage who is looking for new ways of connecting aboriginal individuals with the health-care system to help reduce the high rates of chronic disease that plague many communities.

Her innovative approach, currently focused on creating a centre for aboriginal infant, child and family health based at St. Michael’s Hospital in Toronto, has already earned her a reputation as a positive force for change. She was recently named a recipient of the prestigious National Aboriginal Achievement Award, which recognizes First Nations, Inuit and Métis individuals across the country.

A core issue that drives her work is the discrimination that native people continue to face. Growing up outside Toronto, Dr. Smylie said, her mother instilled in her the belief that everyone is equal. But as she got older, she saw that she had been sheltered from some harsh realities and that many people held biases toward aboriginal Canadians.

While she believes the historical pattern of discrimination and, in some cases, lack of respect for aboriginal communities is beginning to shift, she said, “We do live in a world where discrimination is still alive and well.

“It just didn’t seem right,” Dr. Smylie added. “It wasn’t the way I was raised.”

She thinks those negative perceptions have, in part, prevented natives from developing stronger connections with the health-care system and breaking the cycle of poverty.

But now Dr. Smylie thinks she has found a way to fix some of those problems and to help turn life around for struggling First Nations, Inuit and Métis communities.

She believes a big obstacle is that the health-care system wasn’t designed specifically with aboriginals in mind. Native Canadians have a distinct culture in which elders pass on vital information about parenting; midwives, rather than hospital-based doctors, help birth children; and age-old traditions play a major role.

Combining those aspects of aboriginal culture with health-care services will help connect more aboriginals with the system, ensure they get the care they need, and help reduce the rates of chronic diseases. In particular, Dr. Smylie is focused on finding ways to deliver those services to children and young families.

“What the research program is about,” Dr. Smylie said, “is identifying why it is that aboriginal children still have barriers when they’re born, what those barriers are, and how we can draw on culture and community knowledge to address them.”

She and her colleagues released a report earlier this month that highlights some of these problems. It found that first-nations people living in Hamilton were more than twice as likely to visit an emergency room, and 25 times more likely to live in crowded conditions, than were the rest of the city’s population. First-nations people were also much more likely to have a child with asthma.

The report also found high rates of poverty, chronic illness and insecurity surrounding food and housing, all of which contribute to serious health issues, Dr. Smylie said. It also noted that health data on native communities is often lacking, meaning the problems facing individuals go unrecognized.

Part of the remedy is creating health services that take into account local knowledge and traditions and the needs of the specific population, Dr. Smylie said. For instance, she believes the revitalization of aboriginal midwifery services, which provide peer support for young families plus a host of other services, could help ensure that children start life on the right foot.

Social networks could also play a major role in communicating important health messages to aboriginal communities, such as proper culture-based parenting techniques. Dr. Smylie plans to start with small-scale pilot projects to see which methods work best and how to execute them.

“My end goal,” she said, “would be that every child born in Canada has the opportunity to live a full and healthy life.”